KR20230035153A - Cannula seal assembly - Google Patents

Abstract

Airtight seal assemblies used during minimally invasive surgery include various features. The wiper seal includes a sealing portion and a surrounding flex portion. The upper and lower surfaces of the sealing portion are inclined with respect to the device to be inserted, and the angle of the upper surface is sharper with respect to the shaft of the device than the angle of the lower surface. This flex part has a corrugated shape, and the support ribs are in one or more corrugation grooves, and these support ribs can easily fold the grooves but prevent the grooves from widening. These support ribs also prevent the sealing portion from inverting. The instrument insertion guide is positioned above the sealing portion and moves laterally with the sealing portion. A latch piece removably secures the seal assembly to the cannula. The anti-reverse piece prevents the wiper seal from reversing when the machine is pulled out. Assemblies may include various combinations of thread assemblies, cannulas, surgical instruments, obturators, endoscopes, and teleoperated medical devices. The seal assembly can rotate within the cannula. These seal assemblies may be used during fabrication or teleoperated surgery.

Description

Cannula seal assembly {CANNULA SEAL ASSEMBLY}

The present invention relates generally to medical devices, and more particularly to cannula threads for minimally invasive surgical systems.

In minimally invasive surgery, air is sucked into the body cavity to provide additional working space at the surgical site. In order to prevent inhalation gas from escaping through the cannula that guides the minimally invasive surgical instrument into the body, one or more airtight seals are usually coupled to the cannula. This airtight seal prevents suction gas from escaping through the open cannula when no surgical instruments are inserted through the cannula, and also prevents gas from escaping through the gap between the cannula and instrument shaft when surgical instruments are inserted through this cannula. .

US Patent No. 6,123,689 (filed March 28, 1997) discloses an example of a device that performs the basic functions required of a minimally invasive surgical cannula seal assembly, "Reusable Cannula with Disposable Seal." The two annular flanges provide a gastight seal for instrument shafts of various diameters inserted through the seal assembly, and the trap door closes to provide a gastight seal when the instrument is removed from the seal assembly. The adapter portion may be coupled over the seal assembly to seal against an instrument shaft having a smaller diameter than the shaft diameter sealed by the annular flange. Instrument shafts include shafts used for endoscopes and other surgical accessories such as obturators.

Current cannula threads for minimally invasive surgery are generally effective, but need improvement. These improvements can occur when a surgical instrument is inserted through a seal, and increase resistance to puncture and tear, reducing or preventing effective sealing (especially for thin film, diaphragm-type wiper seals), and eliminating the need for two or more seals. effective accommodation of the instrument shaft for a wide range of shaft diameters, minimizing operating costs; reduced frictional force on the instrument shaft as it is inserted and withdrawn through the seals (so that the instrument can be remotely controlled with increased precision; By reducing any other force along the insertion/extraction axis, and by reducing the tendency of the thread to reverse as the instrument shaft reciprocates, more accurate insertion/extraction axis force feedback can be provided to the teleoperating surgeon), reduced These include part cost, easy and economical manufacturability, and easy assembly during manufacture and intraoperative use.

The following summary introduces certain features of the present invention for a basic understanding. This summary is not an extensive summary of the invention and is not intended to identify key elements or to delineate the scope of the invention. Although this summary contains information relating to various features and embodiments of the present invention, its purpose is to present some specific embodiments in a general form as excluded from the more detailed description below.

One feature includes a feature that prevents the thread from inverting as the surgical instrument passes through it.

In one feature, the wire seal includes features that provide relatively high friction against the instrument shaft being inserted through the yarn and relatively low friction against the surgical instrument shaft being pulled out through the yarn.

In one feature, an instrument insertion guide extends distally from the top of the seal assembly housing to the wiper seal below to assist in guiding surgical instrument tips through the seal without damaging the seal.

In one feature, an instrument insertion guide is coupled to the top of the wiper seal to assist in guiding surgical instrument tips through the seal without damaging the seal.

In one feature, the seal assembly includes a single latch piece that removably secures the seal assembly to the cannula bowl.

In one feature, the seal assembly includes an anti-reverse feature that prevents the thread from being pulled in the proximal direction when the surgical instrument is pulled through the thread.

In one feature, the seal is maintained between the seal assembly and the cannula as the seal assembly rotates within the bowl of the cannula.

These and other features are described in more detail below.

1 is a schematic cross-sectional view of a seal assembly.
1A is a schematic cross-sectional view of a portion of the seal assembly shown in FIG. 1;
2 is a cross-sectional front view of an example surgical instrument seal assembly.
3 is a top perspective view of a wiper seal embodiment; FIG. 3A is a cross-sectional top perspective view of the wiper seal embodiment shown in FIG. 3 , and FIG. 3B is a top plan view of the wiper seal embodiment shown in FIG. 3 . 3C-3AB are top and perspective views of various wiper seal support rib configurations.
FIG. 4 is a bottom perspective view of the wiper seal embodiment shown in FIG. 3 , FIG. 4A is a cross-sectional bottom perspective view of the embodiment shown in FIG. 3 , and FIG. 4B is a bottom plan view of the embodiment shown in FIG. 3 .
5 is a cross-sectional front view of a portion of another seal assembly embodiment.
6 is a cross-sectional front view of a portion of another seal assembly embodiment.
7 is a cross-sectional front view of a portion of another seal assembly embodiment.
8 is a cross-sectional front view of a portion of another seal assembly embodiment.
9 is a cross-sectional front view of a portion of another seal assembly embodiment.
10 is a cross-sectional front view of a portion of another seal assembly embodiment.
11 is a perspective view of an example combination of a spacer and latch piece for a seal assembly.
12 is a cross-sectional view of an example latch portion of the spacer and latch piece shown in FIG. 11 where the seal assembly is coupled to the cannula.
13A is a top perspective view of an example seal assembly with the top of the seal assembly housing removed to show an embodiment of an optional seal anti-inversion piece, and FIG. 13B is a top perspective view of the seal assembly with the top of the housing of the seal assembly in place. am. 13c-13i are plan views of various anti-reverse piece configurations.
14 is a perspective view of an example of an obturator;
15A is a cross-sectional view of a close-up of an exemplary obturator coupled to the top of a seal assembly, and FIG. 15B is a cross-sectional view taken at right angles to the view of FIG. 15A.
16 is a perspective view of a medical device assembly comprising a cannula, a seal assembly latched to the cannula, and an obturator latched to the seal assembly.
17 is a perspective view of a cannula and seal assembly coupled together and mounted on the distal end of a remote manipulator.
18 is a perspective view of a telecontrolled medical device 178 incorporating a cannula and seal assembly.

The description and accompanying drawings illustrate exemplary embodiments and are not to be construed as limiting, as the claims define the scope of the invention. Various mechanical, compositional, structural, electrical and operational changes may be made without departing from the scope of the present description and the claimed subject matter including equivalents. In some instances, well-known circuits, structures, or techniques have not been shown or described in detail in order not to obscure the specification. Headings are intended to assist the reader and do not form part of this description.

Also, the terms of the present invention are not intended to limit the present invention. For example, spatially related terms such as "below", "lower", "above", "top", "proximal", "distal", etc., refer to one member or feature of another member or feature as shown in the drawing. Can be used to describe a relationship with wealth. These spatially related terms are intended to include, in addition to the positions and orientations shown in the figures, different positions (ie, spatial positions) and orientations (ie, rotational displacements in space) of the device in use or operation. For example, if the device in the figures is turned over, an element described as “below” another element or feature will be “above” the other element or feature. Thus, the term "below" can include both the position and orientation of above and below. The device may otherwise be oriented (rotated 90 degrees or in other directions) and spatially related descriptions used herein interpreted accordingly. Likewise, descriptions of movement along and around various axes include various specific device positions and orientations. Also, geometric terms such as "parallel", "perpendicular", "round", or "rectangular" do not require absolute mathematical precision unless the context indicates otherwise. Instead, these geometrical terms allow for variations due to manufacturing or equivalent functions. For example, if a member is described as "round" or "approximately round," elements that are not precisely circular (eg, slightly rectangular or multisided polygons) are also included in the description.

Also, unless the context indicates otherwise, the singular forms “a” and “the” are intended to include the plural as well. And, the terms “comprise,” “comprising,” and the like indicate the presence of a described feature, step, operation, element, and/or component but specify the presence of one or more other features, steps, operations, elements, components, and/or components. or the presence or addition of groups. Components described as coupled may be coupled directly, electrically or mechanically, or may be coupled indirectly through one or more intermediate components.

Whenever practiced, elements described in detail for one embodiment or application may be included in other embodiments or applications not specifically shown or described. For example, if an element is described in detail for one embodiment and not for a second embodiment, the element may nevertheless be claimed to be included in the second embodiment. Thus, in order to avoid unnecessary repetition in the following description, one or more elements that are shown and described in connection with a single embodiment or application may be specifically described otherwise or one or more elements may render the embodiment non-functional or such elements If two or more of the do not provide collapsible functionality, they may be incorporated into other embodiments, or features.

The term "flexible" in connection with parts such as mechanical structures, elements, or assemblies should be interpreted broadly. In fact, this term means that these parts can be repeatedly bent and returned to their original shape without harming the parts. Many "rigid" objects have a slight inherent elastic "bend" due to material properties, even though such objects are not considered "flexible" when the term is used. Flexible parts can have infinite degrees of freedom (DOF). Examples of such components are closed, bendable tubes (eg made of NITINOL, polymers, soft rubber, etc.), and spiral coil springs, which can be bent into a variety of simple or complex curves, often without significant cross-sectional deformation. includes Other flexible parts can approximate these infinite DOF parts by using a series of closely spaced components similar to the serpentine arrangement of the spine. In this stapes arrangement, each component is a short link in the kinematic chain, and the movable mechanical constraints between each link (e.g., pin hinge, cup and ball, live limb, etc.) limit the relative motion between these links. One (eg pitch) or two (eg pitch and yaw) DOFs are possible. A short, flexible part may itself be a kinematic chain made of multiple coupled links, but may function and be modeled as a single mechanical constraint (joint) providing more than one DOF between two links in a kinematic chain. One skilled in the art will understand that the flexibility of a component can be described in terms of stiffness.

Features of the present invention are primarily described in terms of embodiments using the da Vinci Xi® Surgical System marketed by Intuitive Surgical, Inc., Sunnyvale, California. However, those skilled in the art will appreciate that the features of the invention disclosed herein may be implemented in a variety of ways, including remotely controlled and, where applicable, non-remotely controlled embodiments. The embodiments for the da Vinci Xi® Surgical System are examples only and do not limit the scope of the inventive features disclosed herein.

seal assembly

1 is a schematic cross-sectional view of a seal assembly 10 for a minimally invasive surgical instrument. Proximal and distal orientation directions are indicated by arrows, and these directions generally generally apply to the present invention and associated figures. As shown in Fig. 1, the seal assembly 10 is positioned at the proximal end of the cannula 20 (usually in the cannula bowl at the proximal end of the cannula), and a part of the minimally invasive surgical instrument 3 is the seal assembly ( 1) and extending through the cannula 2 to the surgical site 4 within the patient's body. The surgical instrument 3 may optionally include various distal parts such as a surgical end effector 3a with one or more mechanical DOFs and a wrist mechanism 3b with one or more mechanical DOFs, so that the surgeon can use the end effector 3a ) direction can be changed. Surgical instrument 3 is inserted distally through thread assembly 1 and cannula 2 and pulled proximally (i.e., reciprocated) several times as the surgeon operates the instrument during the surgical procedure. A latch (not shown) holds the seal assembly 1 in place relative to the cannula 2, as described in detail below.

As shown, the seal assembly 1 includes a lower housing 5 and an upper housing 6 which when assembled together form a seal assembly housing. The lower housing 5 and the upper housing 6 are shown as two separate pieces joined to form a single complete housing, and optionally this complete seal assembly housing is formed as a single piece. The seal assembly 1 further includes a wiper seal 7 and a fluid (eg gas, liquid) backflow prevention seal 8 . A number of wiper seal 7 embodiments are described in detail below. An anti-backflow seal 8 is optionally available in which one or more slits are kept closed (by the inherent elastomeric material properties and by hydraulic pressure to the distal side of the seal) to prevent fluid backflow through the seal, but the fluid or It may be one of a number of types of seals that are open to allow objects to pass through these seals. These yarns include single slit "duckbill" shapes, crossed 3-slit 3-ply shapes, crossed 2-slit ("cross-slit" or "cross") shapes, and S-curved shapes. Other non-return type seals may be used (eg trap doors, check valves, etc.).

In use, the anti-backflow seal 8 is closed as shown by the broken line alternative position 9, which prevents surgical suction gas or other fluids from escaping through the cannula when no surgical instrument is inserted into the cannula. . When the surgical instrument is inserted into the cannula, the non-return seal 8 is opened and the wiper seal 7 seals against the shaft of the surgical instrument to likewise prevent suction gases or other fluids from escaping through the cannula. Thus, the wiper seal 7 and the anti-backflow seal 8 cooperate to prevent suction gases or other fluids from escaping through the cannula during surgical procedures, regardless of whether surgical instruments are inserted into the cannula.

As shown in Fig. 1, the wiper seal 7 and the anti-backflow seal 8 are sandwiched between the lower housing 5 and the upper housing 6, but there is no adhesive or other means of fixing the seal inside the housing. Other configurations for retaining the seal inside the seal assembly housing, such as for use, are also possible. One or more optional spacers (not shown) may also be sandwiched between the upper and lower housings, as described below.

FIG. 1 also shows that the seal assembly can be configured to allow inhalation gas to enter the patient and allow gas and airborne particulates (eg smoke) to exit the patient, whether or not an instrument is inserted through the seal assembly. As shown, intake/exhaust gas 10 enters/exits through port 11 of seal assembly 1 . The port 11 passes through the lower housing 5 and is in the seal assembly housing as shown. Then, the entered gas flows between the inner wall of the lower housing 5 and the outer wall of the non-reflux chamber 8 and passes through the cannula or passes through the gap between the surgical instrument 3 and the inner wall of the cannula and enters the patient. Exhaust gases follow the reverse path. An example of a configuration allowing intake/exhaust gas to pass through the seal assembly 1 will be described in detail below. Two or more ports may optionally be used to ensure a clear path for gas to pass through the seal assembly.

In some embodiments, seal assembly 1 includes an instrument insertion guide 12 located on the proximal side of wiper seal 7 . The instrument insertion guide 12 guides the distal end of the surgical instrument to prevent, for example, the instrument end effector 3a from puncturing, tearing, snagging, or damaging the wiper seal 7 when the instrument is inserted. It helps to guide into the wiper seal (7). As described in detail below, in some embodiments, the instrument guide 12 is fixed relative to the seal assembly housing (eg, optionally formed in one piece with the upper housing 6), and other In an embodiment the instrument guide is formed as a separate piece from the seal assembly housing, and as a separate piece may be fixed relative to or move with the seal assembly housing.

In one aspect, a combination of a seal assembly 1 and a surgical instrument inserted through the seal assembly 1 is considered an assembly. In another feature, the combination of seal assembly 1 and cannula 2 is considered an assembly. In another feature, the combination of the thread assembly 1, the cannula 2, and surgical instruments inserted into the thread assembly 1 and the cannula 2 is considered an assembly. In two additional features, the combination of the seal assembly 1 and the cannula 2, and the combination of the seal assembly 1, the cannula 2, and surgical instruments inserted into the seal assembly 1 and the cannula 2. This extends to include remotely controlled medical devices that control movement of surgical instruments. Telecontrolled medical devices such as the da Vinci Xi® Surgical System sold by Intuitive Surgical, Inc., Sunnyvale, California are known and such medical devices are also referred to by terms such as “surgical system” or “surgical robot”. As described above and below, the seal assembly is a component that allows the teleoperated medical device to perform surgery by maintaining an appropriate airtight seal to the surgical instrument.

FIG. 1A is a schematic cross-sectional view of a portion of a seal assembly 1 similar to FIG. 1 but with a number of components omitted for clarity. Longitudinal and lateral directions are indicated by arrows, where longitudinal means a direction approximately parallel to the instrument insertion and pull-out axis, and lateral direction means a direction approximately perpendicular to the instrument insertion and pull-out axis. 1a shows the shaft of the surgical instrument 3 inserted through the wiper seal 7 . The wiper seal 7 includes an inner sealing portion 13 and an outer flex portion 14 surrounding the sealing portion 13 . When the surgical instrument 3 is inserted and withdrawn through the wiper seal 7, the flex portion 14 allows the sealing portion 13 to move distally and proximally along the long axis A. The flex part 14 also allows the sealing part 13 to move laterally (horizontally) within the surgical instrument housing. The sealing portion 13 includes an upper annular surface 15 and a lower annular surface 16 opposite to the upper surface 15 . The upper face 15 and the lower face 16 intersect at an annular wiper seal lip 17 to form a circular opening, which lip 17 seals against the shaft outer face 18 of the surgical instrument 3. . Therefore, the sealing part 13 is relatively thick compared to the flex part 14 and has higher rigidity than the flex part 14 . However, the sealing portion 13 is sufficiently flexible in the lateral direction to accommodate various machine shaft diameters. In one embodiment, for example, the wiper seal 7 seals effectively against surgical instrument shaft diameters in the range of 4.7 to 9.4 mm (also referred to as the 5-8 mm range). In another embodiment, the wiper seal 7 effectively seals against surgical instrument shaft diameters in the range of 9.7 to 14.2 mm (also referred to as the 10-12 mm range). These wiper seals may be sized to accommodate a variety of different diameter ranges, or may be made of materials most appropriate to work with a single specific machine shaft diameter.

As shown, the upper surface 15 is inclined at an angle α with respect to the shaft of the device 3 and the lower surface 16 is inclined with respect to the shaft of the device 3 at an angle β. Stated this another way, angles α and β are inclined with respect to the major axis A defined between the top and bottom of the seal assembly such that the surgical instrument is inserted and withdrawn along the major axis A. Angle α is smaller (more acute) than angle β. Accordingly, the radial width of the upper surface 15 is greater than the radial width of the lower surface 16 . As the surgical instrument 3 is inserted distally through the wiper seal 7, the contact between the seal lip 17 and the upper surface 15 to the shaft outer surface 18 moves the sealing portion 13 distally. there is a tendency Similarly, as the surgical instrument 3 is withdrawn through the wiper seal 17, the contact between the lower surface 16 and the seal lip 17 to the shaft outer surface 18 moves the seal 13 in the proximal direction. tend to do

The relatively thicker sealing portion 13 and the angular and/or radial widths of the upper and lower surfaces 15 and 16 provide a number of advantages. Typical thin-film diaphragm seals have a uniform or nearly uniform thickness, so that when the device is inserted, it is punctured or torn by the device tip. The greater thickness of the sealing portion 13 relative to the flex portion 14 helps protect it from punctures or tears when the instrument is first inserted, but the flex portion 14 provides a full seal longitudinal and Provides lateral flexibility. As will be discussed below, in some configurations, flex portion 14 provides superior flexibility characteristics to wiper seal 7 compared to typical thin-film diaphragm seals because flex portion 14 is not subject to contact by an instrument. This is because it can be made thinner. This overall flexibility accommodates longitudinal and lateral movement of the instrument shaft within the seal assembly during initial insertion, removal, and use. The relatively steep angle α of the top surface 15 helps guide the instrument tip into the configuration formed by the seal lip 17, further reducing the risk of puncture or tearing. Along the sealing portion 13 increasing the outer thickness, the thickness of the sealing portion 13 coming from the lip 17 being compressed against the machine shaft to form a thicker contact with the machine shaft is (18) to break the seal by creating an opening between them, the problem of a portion of the seal lip (17) detaching from the instrument shaft surface (18) and sagging in a rectangular shape when the shaft is moved laterally within the seal assembly. help reduce or eliminate This situation is sometimes referred to as a “cat-eye” condition due to the shape of the final seal opening, and becomes more of a problem with machine shaft diameters at the lower end of the range of diameters that thin-film diaphragm seals can accommodate. Because of the almost triangular cross-sectional shape of the seal 13, with its apex at the lip 17, the circular opening easily expands to accommodate a variety of machine shaft diameters, while the wiper seal function is preserved and the seal 13 Longitudinal bending is significantly reduced. With a generally smaller amount of material near the circular opening, the seal 13 can be compressed laterally outward with relatively less resistance, and with a generally larger amount of material far from the circular opening, the circular opening The resistance to lateral compression of the sealing portion 13 outwards tends to increase as is further expanded.

Due to the relatively larger radial width of the upper face 15 compared to the radial width of the lower face 16, a relatively larger portion of the upper face 15 compared to the lower face 16 is exposed to the instrument shaft surface when the instrument is inserted and withdrawn. (18) will be contacted. In other words, the contact area between the upper surface 15 and the machine shaft is larger than the contact area between the lower surface 16 and the machine shaft. Due to this contact, a relatively high frictional force is developed between the wiper seal 7 and the instrument shaft surface 18 as the instrument is inserted and relatively low as the instrument is withdrawn. The lower frictional force during appliance withdrawal helps prevent the wiper seal 7 from being pulled proximally when the appliance is completely withdrawn, thereby preventing the wiper seal from proximally inverting through the upper opening in the seal housing. In the wiper seal embodiment shown in the Figures and described below, the radial width (i.e., contact area) of upper surface 15 to provide a relatively high instrument insertion friction force, even if angles α and β are equal or angle α is greater than angle β. Those skilled in the art will understand that the sealing portion 13 can optionally be configured to be larger than the radial width of the lower surface 16 . Those skilled in the art will find it necessary to provide a good sealing function with low friction (e.g. low enough to avoid a stick-slip condition), especially in remote controls where smooth control is needed as the machine shaft moves constantly back and forth through the seal. Those skilled in the art will understand. However, one skilled in the art will also appreciate that it is desirable to provide adequate resistance to instrument insertion so that the instrument does not inadvertently slide through the thread and injure the patient (due to the instrument's own weight during manual laparoscopic procedures). The described sealing portion of the wiper seal provides acceptable insertion/extraction friction as well as this increased resistance to insertion friction. Other wiper seal 7 features as well as additional asymmetric insertion/extraction resistance features are detailed below.

As shown in FIG. 1A , a flex part 14 is attached to the outer periphery of the sealing part 13 in the middle of the longitudinal direction between the upper surface 15 and the lower surface 16 . Flex portion 14 is also shown longitudinally aligned with lip 17 . However, as an option, flex portion 14 is attached to the periphery of seal portion 13 at various longitudinal positions, including extreme proximal and distal positions. Likewise, flex portion 14 is optionally positioned in various longitudinal relationships with lip 17 . An example of such longitudinal attachment and lip alignment is shown in detail below.

Example 1

2 is a cross-sectional front view of an example of a surgical instrument seal assembly 20 . The seal assembly 20 includes a lower housing 21a and an upper housing 21b which when assembled together form a cylindrical seal assembly housing 21 . As shown, during manufacturing, the lower housing 21a and upper housing 21b are first aligned with the hexagonal holes and interference pins, then ultrasonic welding is used to secure the lower housing 21a and upper housing 21b together. let it Other well-known permanent bonding techniques may be used, such as permanent compression fit or the use of adhesives. In one embodiment, lower housing 21a and upper housing 21b are made of rigid polycarbonate, optionally other rigid materials such as plastic or metal may be used.

The lower housing 21a includes a distal end 22 that is inserted into the cannula bowl at the proximal end of a surgical cannula (not shown), and a proximal end 23 that is external to the cannula. The proximal end 23 is optionally generally larger than the distal end 22, and a relief surface 24 under the proximal end 23 is seated and held over the proximal end of the cannula. The housing 21a further includes an annular groove 25 on its outer wall surface 26 . The O-ring 27 is inserted into the groove 25, and when the seal assembly 20 is inserted into the cannula bowl, the O-ring 27 seals against the inner wall surface of the cannula bowl so that the suction gas flows into the cannula bowl. It is prevented from escaping between the side wall and the outer wall of the lower housing 21 . As described in more detail below, O-ring 27 allows the seal assembly to rotate within the cannula bowl while maintaining a seal between the seal assembly and the cannula bowl. One skilled in the art will generally refer to the o-ring 27 as a cannula seal and functions to seal between the outer wall of the seal assembly and the inner wall of the cannula bowl, in some embodiments allowing rotation of the seal assembly within the cannula bowl while retaining the seal. It will be appreciated that various packing or gasket types of seals are shown.

The lower housing 21a further includes an inner wall surface 28 that may taper slightly laterally outward toward the distal end 22 to increase lateral movement of the non-return seal (e.g., an extended backflow seal). see FIG. 7 where the anti-seal is shown). As shown in Figure 2, the inner wall surface 28 is optionally slightly necked down near the upper housing portion 21b. This neckdown increases the structural strength in the lower housing portion. Also, as shown in Figure 2, there are a number of optional radial-inwardly-protruding ribs 29 in this neckdown area. The ribs 29 help prevent the outer wall of the regurgitation seal from blocking gas flow as gas passes between the inner wall of the housing and the outer side wall of the regurgitation chamber to enter or exit the surgical site through the port of the seal assembly. .

As shown in FIG. 2, the lower housing 21 also includes a valve body 31, a rotary valve member 32, an external fitting 33 (e.g., a threaded luer lock as shown). ), an internal fitting 34 (eg, a Luer taper fitting as shown), and an optional gas valve 30 comprising a gas channel 30a. As shown, the valve member 32 is snap-fitted and rotationally fixed to the valve body 31 using an annular retainer flange 35 . In some embodiments, one or more optional support ribs 30b are disposed between the valve body 31 and the seal assembly housing 21 to provide additional structural support to help prevent the valve 30 from falling out of the housing 21. provides strength. As shown, the lower housing 21a, the valve body 31, the outer fitting 33, and the support rib 30b are integrally formed as a single piece, and may optionally be formed as two or more pieces joined together. can During the surgical procedure, a suction gas source (not shown) may be coupled to the fittings 33 and 34 and the valve member 32 rotated to allow gas to flow through the channel 30a and into the seal assembly. Alternatively, an exhaust gas sink (not shown; e.g., a vacuum source) may be coupled to the fittings 33, 34, and the valve member 32 may direct gas outwardly from the seal assembly through the channel 30a. It is rotated so that it flows.

The upper housing 21b includes an optional distal tapering annular funnel portion 36 leading to an optional annular instrument insertion guide 37 extending distally into the underlying wiper seal. The funnel portion 36 and the instrument insertion guide 37 together form a circular hole 38 centered on the longitudinal centerline of the seal assembly into which the instrument is inserted, in the upper housing 21b. The diameter of the hole 38 is larger than that of the wiper seal below, and the relationship between the diameter of the hole 38 and the dimension of the upper surface of the wiper is explained in detail below. Funnel portion 36 helps guide the surgical instrument tip toward aperture 38 and instrument guide 37 helps align and guide the instrument tip for insertion through the underlying wiper seal.

Housing 21b optionally includes one or more latch receiving features 39 that allow objects to be removably coupled to housing 21 . As shown, latch receiving feature 39 extends and engages a sealer latch (not shown) through the inner surface of upper housing 21b to retain the sealer (not shown) fully inserted into the seal. It is a window that allows This sealer latch is engaged below the periphery forming the window. The cannula, thread, and obturator together form an assembly that allows a surgeon to insert the cannula through a patient's body wall. It will be appreciated that the illustrated latch receiving feature 39 represents a number of well-known latch mechanisms that will allow an obturator or other object to be removably coupled to the top of the housing 21 . In another example, a latch on a second seal assembly (not shown) holds the second seal assembly against the top of the housing 21 . See U.S. Patent No. 6,123,689 (showing a "reducer" seal that can be removably coupled to the top of the main seal assembly). The second seal assembly includes a wiper seal hole having a smaller diameter than the diameter of the wiper seal hole in the housing 21 . When coupled to the housing 21, the second seal assembly forms additional various combinations similar to those described elsewhere herein.

As shown in Fig. 2, a non-return seal 40 is sandwiched between the lower housing 21a and the upper housing 21b. As described in this embodiment, the non-return seal 40 is a cross-slit seal. The thickness of each of the folding sidewalls 41 of the non-return seal 40 tapers slightly towards the distal end 42 of the seal 40. The thicker folding sidewall 41 at the proximal end of the seal 40 helps the non-return seal snap back into a closed position when the appliance is removed. The thinner folding sidewall 41 at the distal end of yarn 40 increases sidewall flexibility between yarn 40 and the device as the appliance is inserted through yarn 40, resulting in lower friction. The relatively thinner distal side wall 41 also helps keep the seal closed when the instrument is removed, fluid back pressure against the outer surface of the side wall. The non-return seal 4 is placed inside the side wall 41 to ensure that sufficient gas flow pushed against the rib 39 passes through the folding side wall 41 when an instrument is inserted through the non-return seal 40. oriented in the lower housing 21a such that one of the folds is aligned with the gas channel 34 (i.e., the adjacent sidewall 41 outer fold is 45 degrees offset from the gas channel 34, as shown); has been The interior of the non-return seal 40 is such that as the wiper seal moves longitudinally and laterally, the non-return seal 40 is deep enough in the longitudinal direction and wide enough in the lateral direction so that the non-return seal 40 does not interfere with the movement of the wiper seal above. has been In an embodiment, the anti-backflow seal 40 is made of a medical grade elastomeric material such as chlorinated polyisoprene, or a rubber material such as silicone, urethane, or the like. Other suitable materials may be used.

FIG. 2 shows an optional annular spacer 43 positioned over the non-return seal 40 and sandwiched between the lower and upper housing portions 21a, 21b. As described in more detail below, in some embodiments, the annular spacer 43 is coupled as a single piece integrally formed with a latch that removably secures the housing 21 to the cannula. In some embodiments, the spacer 43 is positioned over both the wiper and the non-return seal so that the outer periphery of the wiper and the non-return seal touch. However, as shown, a spacer 43 is positioned between the wiper and the non-return seal to provide more longitudinal space between the wiper and the proximate end of the non-return seal so that the wiper seal can be moved without contact interference from the non-return seal. enable it to function properly. The spacer 43 is one or more seals that compress either or both the anti-return seal and the wiper seal when the upper and lower housing pieces are secured together to ensure an airtight seal between each seal and the housing and to prevent each seal from rotating within the housing. An annular boss is included as an option.

As shown, the wiper seal 44 is positioned over the annular spacer 43 such that the wiper seal is over (close to) the non-return seal 40 . The instrument hole in the wiper seal 44 is aligned over the intersection of the cross slits of the non-return seal 40 such that the instrument passes through the center of both the wiper and non-return seal. The details of the wiper seal are described in more detail below.

As shown, an optional annular spacer 45 is positioned over (close to) the periphery of the wiper seal 44 . When used, the annular spacer 45 helps distribute the pressure of the upper housing 21b against the wiper seal 44. Additionally, the annular spacer 45 may optionally include a wiper seal anti-reverse feature, as described in more detail below.

2 shows a wiper seal 44 positioned over a non-return seal 40 in seal housing 21, sandwiched along optional spacers 43, 45 between lower housing 21a and upper housing 21b. ) is shown.

wiper seal

3 is a top perspective view of a wiper seal embodiment; FIG. 3A is a cross-sectional top perspective view of the wiper seal embodiment shown in FIG. 3 , and FIG. 3B is a top plan view of the wiper seal embodiment shown in FIG. 3 . FIG. 4 is a bottom perspective view of the wiper seal embodiment shown in FIG. 3 , FIG. 4A is a cross-sectional bottom perspective view of the embodiment shown in FIG. 3 , and FIG. 4B is a bottom plan view of the embodiment shown in FIG. 3 . To avoid tedious description, the wiper seal features described above, as well as various features described for this wiper seal embodiment, apply to other wiper seal embodiments described above and below.

2, 3, 3a, 3b, 4, 4a and 4b, the wiper seal 44 has a substantially annular shape and seals with the annular outer circumferential portion 45, the annular inner sealing portion 46, and the outer circumferential portion 45. An annular flex portion 47 between the portions 46 is included. The outer periphery 45 supports the wiper seal 44 within the housing 21 so that the seal 46 is longitudinally and laterally damped when the instrument shaft passing through the wiper seal 44 moves inside the housing 21. can move As shown, the outer periphery 46 has optional small annular bosses on its distal side, and various other optional configurations (eg, proximal annular bosses, interrupt annular bosses or protrusions, etc.) It may be used to mount the wiper seal 44 to the seal assembly housing. The sealing portion 46 functions as generally described with respect to FIGS. 1 and 1A. It includes an annular upper face 48 and an annular lower face 49 which meet at a circular seal lip 50, forming a hole through which the surgical instrument shaft is inserted and withdrawn. Seal lip 50 seals against the outer surface of the surgical instrument shaft. The seal lip 50 may be formed as a single, circular face or, optionally, as other surface shapes such as flat, corrugated, or the like. Optionally, one or more small, discrete annular rings are disposed on the lip 50 to seal against the machine shaft. The seal 46 is flexible to accommodate a variety of machine shaft dimensions (eg, about 5-8.5 mm or about 10-12 mm - the dimensions of the seal 46 can be varied to suitably accommodate other dimensional ranges). do. It can be seen that the radial width of the upper surface 48 is greater than the radial width of the lower surface 49, and the angle between the upper surface 48 and the inserted instrument shaft is steeper than the angle between the lower surface 49 and the inserted instrument shaft. .

The flex portion 47 surrounds the seal portion 46 and (i) allows the seal portion 46 to move distally and proximally (longitudinal) within the seal assembly, and (ii) seal portion 46. (iii) a seal that extends radially outward when a large diameter instrument shaft is inserted. Receive section 46. Thus, the advantages of various features of the sealing portion 46 are combined with the advantages of the flex portion 47 . As shown, flex portion 47 has a generally annular shape, alternatively described as an annular corrugated configuration, comprising one or more upper (nearly oriented) annular folds and/or one or more lower (distal oriented) annular folds. It has a folding bellow configuration, wherein an annular groove separates an adjacent upper fold from an adjacent lower fold (ie, the groove is formed by reversing the folds). These folds act as hinges, although the flex portion 47 material between the folds can also be compressed. In other embodiments, other suitable flex portion 47 may be used, including, for example, a flat (planar), annular diaphragm having a constant or variable thickness.

In the illustrated embodiment, the flex portion 47 is coupled to the sealing portion 46 at an inner upper annular fold 51 and to the outer periphery 45 at an outer upper annular fold 52 . Between the upper annular folds 51 and 52 there is a lower annular fold 53. As a result, a lower annular groove 54 is formed between the sealing portion 46 and the lower annular fold 53, and an upper annular groove 55 is formed between the upper annular folds 51 and 52. The support rib 56 is located in the lower annular groove 54, and the support rib 57 is located in the upper annular groove 55. As shown, there are five each of support ribs 56, 57, although other numbers (eg, 3, 4, 6, or more) may be used. Although the individual support ribs 56 and 57 are located opposite and inverse of the wiper seal 44 opposite each other, they can be arranged in other mutually relative orientations. Also, in some embodiments, the number of support ribs 56 may be different from the number of support ribs 57 . And, the support ribs 56 and 57 can optionally be symmetrically or asymmetrically spaced within the annular groove. Symmetrical spacing of three or more support ribs tends to keep the resistance to motion constant in all lateral directions, while asymmetric spacing (or using only two support ribs oriented opposite to each other) provides resistance to motion in one or more lateral directions. It tends to help with exercise.

As shown in FIGS. 4 , 4A and 4B , the support ribs 56 are equally spaced from the lower annular groove 54 . Each support rib 56 has a faceted semicircular cylinder portion 58 coupled to the sealing portion 46 on both sides, and a web portion 59 extending between the semicircular cylinder portion 58 and the outer wall of the lower annular groove 54. ) has two parts. The rectangular cylinder portions 58 of these support ribs 56 are arranged so as to form a scallop pattern approximately around the sealing portion 46 . As shown, the semicircular cylinder parts 58 are slightly separated from each other at the sealing part 46 and can optionally touch each other at the sealing part 46 .

3, 3a, and 3b, the support ribs 57 are equally spaced from the upper annular groove 55. Each support rib 57 is a faceted quadrant cylinder portion 60 coupled to the outer wall of the upper annular groove 55 on one side, and a web portion extending between the other side of the portion 60 and the inner wall of the upper annular groove. (61) has two parts. It can be seen that the shape of the support rib 57 is similar to that of the support rib 56, except that it has only approximately half of the semicircular cylindrical portion of the support rib 56.

Both support ribs 56 and 57 may have other shapes. For example, support rib 57 may have a semi-circular cylinder portion, or support rib 56 may have a quarter-circular cylinder portion. Other support rib shapes include a single, smooth (eg S shape) or sharply angled (eg zigzag) folding piece between the inner walls of the groove. The oblique portion of support rib 57 and the lower portion of support rib 57 may be faceted as described or shown, or may be approximately parallel to the lateral direction of yarn 44 .

It can be seen from Figs. 2, 4, 4a, 4b that the attachment portion of the support rib 56 to the outer wall of the lower annular groove 54 extends below (towards the end) the level of the sealing portion 46. This configuration acts as an anti-reverse feature to help prevent pulling the seal 46 in the proximal direction (i.e., reversing the seal) during instrument pull-out and unfolding top annular fold 51. This configuration of support ribs 56 provides relatively little resistance to compression and relatively high resistance to expansion. Thus, the semi-circular cylindrical portion 58 of the support rib 56 can stretch open to accommodate larger machine shaft diameters, thereby symmetrically compressing the lower annular groove 54. The semicircular portion 58 also allows the lower annular groove 54 to be compressed asymmetrically as the sealing portion 46 moves laterally into the flex portion 47 .

Thus, both the anti-reverse benefit and low resistance to compression of the annular groove are provided. Due to this semi-circular cylinder shape, the support rib 56 can extend a relatively short distance with relatively low resistance as the semi-circular wall is pulled straight into a V shape, and then provides a relatively high resistance to further extension, providing support The rib material itself needs to be stretched. Also, due to this semicircular cylinder shape, the support rib 56 can be folded almost completely on itself with little resistance. One of ordinary skill in the art will also appreciate that the semicircular cylinder shaped vertical wall facilitates shaping so that a complete wiper seal can be formed as a single, uniform piece. It will be appreciated that similar features and advantages exist in the support rib 57 configuration discussed below, as well as other support rib 56 configurations discussed above and below.

Also, while specific embodiments have been described, many variations such as reversing the web and semi-circular cylinder orientation to bring the web closer to the seal (depending on the groove configuration), changing the semi-circular cylinder shape to include different curved or straight sides, etc. this is possible Thus, in general, the illustrated support ribs 56 can be described as having two walls, with a first side of each wall anchored to one of the side walls of the groove 54 and a second side of each wall. The side is anchored to the other one of the side walls of the groove 54. And also, the level at which the wall of the support rib 56 joins the outer wall of the groove 54 extends below (towards the end) the level at which the wall of the support rib 56 joins the inner wall of the groove 54. . Further, although the inner wall of the groove 54 has been described as being formed by the sealing portion 46, the support rib 56 may optionally be disposed in any groove within the flex portion 47.

In some wiper seal 46 embodiments, a lubricant 62, such as medical grade silicone lubricant, is disposed in one or more of the pockets formed between the semicircular cylindrical portion 58 of the support rib 56 and the sealing portion 46. . As the surgical instrument is inserted and withdrawn through the sealing portion 46, after some lubricant 62 is pushed out of the pocket by the flexing of the sealing portion 46 and of the flex portion 47, the lower surface 49 Lubricate the contact between the surgical instrument shaft and the sealing portion 46 across the . One suitable lubricant is NuSil Technology LLC's MED-420 (~5,000 cP). Another suitable lubricant is NuSil's MED-361 (˜12,5000 cP), and other suitable lubricants of various viscosities may be used.

2, 3, 3a, 3b, due to the angle of the sidewall of the upper annular groove 55 with respect to the long axis, the orientation of the support rib 57 in the upper annular groove 55 is the same as that of the support rib 56 in the lower annular groove 54. ) direction is approximately reversed. The level at which each support rib 57 attaches to the outer wall of the upper annular groove 55 is such that each support rib 57 is attached to the inner wall of the upper annular groove 55 (the upper portion of which is the flex portion 47 is the sealing portion). (46)) extends above (in the proximate direction) the level to which it is attached. This configuration helps to prevent the seal 46 from being pushed distally and possibly unfolding the lower annular fold 53 during instrument insertion. The quadrant cylindrical portion 60 and web 61 combination of support ribs 57 function similarly to support the semi-circular cylindrical portion 58 and web 59 combination of support ribs 56, similar configurations described above. transformation is possible It can be seen that each support rib 57 is somewhat larger than each support rib 56 . Upper annular groove 55 folds symmetrically and easily as seal 46 expands to accommodate a relatively larger machine shaft diameter, and as seal 46 moves laterally, groove 55 Folded easily asymmetrically, the quarter-circular cylinder portion 60 serves to further reduce its resistance to collapse compared to the semi-circular cylinder portion 58. However, in some embodiments, support rib 57 includes a semicircular cylindrical portion (or variant) similar to support rib 56 . And, for the support ribs 56 in the plurality of lower annular grooves, when the flex portion 47 includes a plurality of upper annular grooves, the support ribs 57 can be disposed in any number of upper annular grooves. there is.

As noted above, various other support rib configurations may be used in the upper or lower groove formed by the annular fold in the flex portion of the wiper seal. 3C and 3D are top perspective views of the wiper seal 46a with equally spaced support ribs 57a located in the flex portion grooves. The support ribs 57a each include a faceted conical portion with the apex directed toward the bottom of the groove and the conical portion wall being longitudinally oriented joined by small webs to the inner and outer walls of the groove. These faceted cones may optionally be rectangular or beveled as shown, and may optionally be round or have other shapes as shown.

3E and 3F are top perspective views of the wiper seal 46b, with equally spaced support ribs 57b located in the flex portion grooves. Each of the support ribs 57b includes a longitudinally oriented cylinder within the groove, the cylinder walls being joined by small webs to the inner and outer walls of the groove. The diameter of the cylinder of the support rib 57b is slightly smaller than the width of the groove at the top of the groove.

3g and 3h are top perspective views of the wiper seal 46c with equally spaced support ribs 57c located in these grooves. Similar to support ribs 57b, support ribs 57c each contain a cylinder oriented longitudinally within the groove, the cylinder walls joined by small webs to the inner and outer walls of the groove. The cylinder of the support rib 57c is larger than the diameter of the cylinder of the support rib 57b, and this diameter is approximately the width of the groove at the top of the groove.

3I and 3J are top perspective views of the wiper seal 46d with equally spaced support ribs 57d located in the flex portion grooves. In contrast to the support rib 57a (Figs. 3c and 3d), the support rib 57d is a faceted semi-conical section, one edge of which is joined to the inner wall of the groove and the other edge to the outer wall of the groove. is bound to

3K and 3L are top perspective views of the wiper seal 46e with equally spaced support ribs 57e located in the flex portion grooves. The configuration of each support rib 57e is illustrated in Figs. 3k and 3l that faceted semicircular cylinder configurations can be positioned in the upper groove and that the faceted semicircular cylinders can have their openings oriented radially outward. Except for that, the configuration is similar to that of the support rib 56 (FIG. 4, 4a, 4b).

3M and 3N are top perspective views of the wiper seal 46f with equally spaced support ribs 57f located in the flex portion upper groove. The configuration of each support rib 57f is similar to that of the support rib 57 (Figs. 3, 3A, 3B).

3O and 3P are top perspective views of the wiper seal 46g with equally spaced support ribs 57g positioned in the flex portion grooves, respectively. The configuration of each support rib 57g is a meandering S-curve, one edge of this support rib is joined to the inner wall of the groove, and the other edge of the support rib is joined to the outer wall of the groove. As shown, the positions of the inner and outer walls of the grooves to which the support ribs are attached are at the same clock positions centered on the wiper seal (12, 4, and 8 o'clock positions are shown), and the serpentine folds of the ribs are at these clock positions. stretched on both sides of

3Q and 3R are top perspective views of the wiper seal 46h in which equally spaced support ribs 57h are located in the flex portion grooves, respectively. The configuration of each support rib 57h is such that the serpentine fold of support rib 57h extends further along the clock face (i.e., has a larger dimension) than the serpentine fold of support rib 57g. Except it is a meandering S-curve similar to support rib 56g (Figs. 3o and 3p).

3S and 3T are top perspective views of the wiper seal 46i in which equally spaced support ribs 57i are positioned in the flex portion grooves, respectively. The configuration of each support rib 57i is such that one edge of the support rib is joined to the inner wall of the groove at one clockwise position centered on the wiper seal and the other edge of the support rib is engaged at a different clockwise position (eg, As shown, it is a serpentine S-curve coupled to the outer wall of the groove (displaced clockwise). As shown in Figures 3S and 3T, the serpentine fold does not extend beyond the clock position where the support ribs are attached to the sidewall. And the clock position at which each support rib is attached to the inner wall of the groove is different from the clock position at which each support rib is attached to the outer wall of the groove. As shown, for example, one rib is attached to the inner wall at the 12 o'clock position and attached to the outer wall at the 1 o'clock position.

3U and 3V are top perspective views of the wiper seal 46j in which equally spaced support ribs 57j are positioned in the flex portion grooves, respectively. The configuration of each support rib 57j is different except that one of the serpentine folds of the support rib (e.g., the fold closer to the sealing portion, as shown) extends beyond the clockwise position where the support rib is attached to the sidewall. The configuration of the bottom support rib 57i (Figs. 3s and 3t) is similar.

3W and 3X are top perspective views of the wiper seal 46k with equally spaced support ribs 57k positioned in the flex portion grooves, respectively. The configuration of each support rib 57k is similar to that of support rib 57i (Figs. 3s and 3t) except that both sides of the serpentine fold of the support rib extend beyond the clockwise position where the support rib is attached to the sidewall. do. This embodiment, along with the embodiment shown in FIGS. 3u and 3v, shows that the serpentine folds of the support ribs do not necessarily have to be symmetrical.

3Y and 3Z are top perspective views of a wiper seal 46m in which equally spaced support ribs 57m are positioned in flex portion grooves, respectively. Support rib 57m is a synthetic variant of the support rib described broadly in FIGS. 3S-3X. As shown, a longitudinal annular wall (i.e., cylinder) 57m is located between the side walls of the groove, then a serpentine support rib is placed between the inner wall of the groove and the annular wall, and the annular wall and the group coupled between the outer walls of As shown, for example, the support rib portion 57m-ii is coupled between the inner wall of the groove and the annular wall 57m-i, and the support rib portion 57m-iii is connected to the annular wall 57m-ii. -i) and the outer wall of the groove. Each support rib portion 57m-ii is configured similarly to support rib 57i (Figs. 3s and 3t), but other configurations may be used. The support rib configuration shown in FIGS. 3Y and 3Z shows that a web of interconnected support ribs can be positioned in one or more of the grooves of the flex portion of the wiper seal. Embodiments include any support rib configuration.

Figures 3aa and 3ab are top perspective views of the wiper seal 46n with equally spaced support ribs 57n positioned in these grooves, respectively. As shown, the support ribs 57n are straight, radial ribs between the inner and outer walls of the groove, respectively. The rib 57n provides strong resistance to sagging and thus provides good seal anti-reverse characteristics when located, for example, in the innermost lower groove of the wiper seal flex portion, as shown. For relatively small radial movements of the sealing portion of the wiper seal (e.g., due to a small increase in the diameter of the machine shaft or a small lateral movement), the ribs 57n rely on the elastic compressive force of their material. And, for a relatively greater radial movement of the sealing portion of the wiper seal, the ribs 57 rely on the elastic buckling of their material.

In FIG. 2 it can be seen that the upper annular fold 51 is optionally sized to be approximately below (at the distal end) the annular distal end of the instrument insertion guide 37 . This configuration also helps prevent the wiper seal 144 from inverting when an instrument is withdrawn, since the instrument insertion guide ( 37) to help prevent it. In addition, the diameter of the device insertion hole 38 is such that the tip of the device to be inserted tends to contact the inclined upper surface 48 of the sealing portion 46 and passes through the wire seal 44 and is pushed so as not to puncture or tear. It has a size such that the outer diameter of the portion 46 protrudes inward. As shown, for example, the diameter of the instrument insertion hole 38 is smaller than the outer circumferential diameter of the upper surface 48, so that the inserted instrument tip will first contact the upper surface 48 of the thick sealing portion 46. . In this configuration, the instrument tip is guided away so as not to contact and potentially damage the relatively thin flex portion 47 .

In addition, there is sufficient space between the lower annular fold 53 and the inner folding sidewall of the non-return seal 42 to allow the seal 46 to move distally and laterally without contacting the non-return seal. It can be seen in Figure 2. In some embodiments, the flex portion 47 may contact the inner sidewall of the non-return seal 42, such as the spacer 43 being relatively thinner or omitted, and the flex portion at or near the contact location. (47) The angle of the outer sidewall still allows the seal 46 to move distally and laterally.

In an embodiment, the wiper seal 44 is made of a medical grade elastomeric material such as chlorinated polyisoprene or a rubber material such as silicone, urethane or the like. Other suitable materials may be used.

2nd example

5 is a cross-sectional, front view of a portion of another seal assembly embodiment 63 having substantially similar configurations, components, features, and modifications to other seal assembly embodiments of the present invention. As shown in FIG. 5 , the seal assembly 63 includes a wiper seal 64 (including a sealing portion 65 ) and a backflow prevention seal 66 . An optional spacer between the wiper seal and the upper housing (e.g., FIG. 2, member 45) has been omitted from the illustrated embodiment so that the top surface of the wiper seal 64 is flush for shaping purposes.

As shown, the sealing portion 65 includes an annular top surface 67 that includes an upper (proximal) concave portion 68 that smoothly transitions into a lower (distal) straight face portion 69 . Upper annular face 67 is made similar to upper annular face 48 . The instrument insertion hole 70 in the housing 71 is sized so that the instrument insertion guide 72 protrudes slightly into the upper concave portion 68 as described above. Additionally, the upper annular fold 73 of the flex portion of the wiper seal 64 contacts or nearly contacts the distal end of the instrument insertion guide 72 . The top surface of the annular fold 73 is optionally shown as flat, and other top shapes can optionally be used to allow the sealing portion 65 to move slightly laterally under the distal end of the insertion guide 72 .

In FIG. 2 , despite the advantages of the relationship between the distal end of the insertion guide 37 and the sealing portion 46, if the instrument is initially inserted extremely off-long axis (e.g., an operating room staff may insert the tip After seating in the instrument insertion hole, the instrument can be tilted up and aligned for insertion; see, for example, FIG. 7 ), the tip being between the top of the upper annular fold 51 and the bottom of the instrument guide 37 can fit into the small gap of In contrast to the wiper seal 440 and its sealing portion 46 of FIG. 2, the upper concave portion 68 (and the upper annular fold 73) of the wiper seal 64 of FIG. It extends in the proximal direction to come into close or contact with the insertion guide 72. This contact or near-contact helps the tip of the off-axis insertion device to avoid contact with the flex portion outside the sealing portion 65, and the tip of the off-axis insertion device to wipe the wiper. Additionally, the relatively sharper angle of concave portion 68 relative to the long axis of the seal assembly helps keep the instrument tip from catching on the seal, allowing the tip to pass through the wiper seal without damaging the seal.

Example 3

6 is a cross-sectional elevational view of a portion of another seal assembly embodiment 74 having substantially similar configurations, components, components, features, and variations to other seal assembly embodiments of the present invention. As shown in FIG. 6 , the seal assembly 74 includes a wiper seal 75 (including a sealing portion 76 ) and a backflow prevention seal 77 . In contrast to the wiper seal 64 (see Fig. 5) and its sealing portion 65, it can be seen that the wiper seal 75 and its sealing portion 76 are relatively deeper (i.e., extend longitudinally). there is. The non-return seal 77 has the same depth as the non-backflow seal 40 (FIG. 2), and in some embodiments may optionally be made deeper to accommodate the wiper seal 75 and its longitudinal movement. there is. An optional spacer between the wiper seal and the upper housing (e.g., FIG. 2, member 45) is omitted from the illustrated embodiment.

Similar to the sealing portion 65 (FIG. 5), the sealing portion 76 includes an annular upper surface 78 that includes an upper concave portion 79 that smoothly transitions to the lower rectilinear portion 80. The lower straight face portion 80 is formed to have a steeper angle than the straight face 69 (FIG. 5) with respect to the inserted surgical instrument (and thus has a larger width (surface area)) (ie, the face angle is the seal assembly is sharper for the long axis of ). Accordingly, the upper annular surface 78 is relatively radially wider than the upper annular surface 67 (FIG. 5). The steep angle of the annular lower straight face 80 also helps the instrument tip pass through the wire seal without puncturing or tearing the relatively soft material used to form the wiper seal. As shown in FIG. 6 , the relative configuration of the instrument insertion guide and wiper seal is similar to the embodiment shown and described with respect to FIG. 5 .

2, 5 and 6, in the center of the wiper seal, the upper surface of the thick seal can have many surface variations, including flat, concave and possibly convex annular surfaces, with various combinations of these surfaces blending together. can know that

Example 4

7 is a cross-sectional elevation view of a portion of another seal assembly embodiment 81 having substantially similar configurations, components, features, and modifications to other seal assembly embodiments of the present invention. The seal assembly 81 includes the seal assembly 82, the non-return seal 83, the wiper seal 84 proximate to the non-return seal 83, and the instrument insertion guide (close to) the wiper seal 84. 85) are included. The instrument insertion guide 85 is fixed to the seal assembly housing and forms an instrument insertion hole 86 in the housing 82 . The insertion guide may be formed as an integral part of the upper part of the seal assembly housing, as shown, or optionally may be formed as a separate part which is then mechanically or adhesively coupled to the upper housing.

7, the instrument insertion guide 85 extends farther (more distally) into the seal assembly housing 21 than, for example, the instrument insertion guide 37 extends into the seal assembly housing 21 (Fig. 2). It extends distally into the housing 82. The distal end of the instrument insertion guide extends to a depth distal to where the wiper seal is coupled to the seal assembly housing. As shown, the instrument insertion guide 85 is between the proximal end 87 and the distal end 88 of the seal assembly housing 82 about a 4/10 depth (more like 3/10 or 5/10). or less). In other words, the instrument insertion guide 85 extends distally beyond the plane of the nearest portion of the wiper seal. In other words, in the groove above the flex portion of the wiper seal, the outer wall of the groove is longer (e.g., about twice as long) as the inner wall such that the seal portion of the wiper seal is near the longitudinal center of the sealing assembly. 5 and 6, the distal end of the instrument inserted into the seal assembly 81 is at an angle that is relatively sharper than the angle at which the tip would have contacted the upper annular surface if the instrument insertion guide had a shorter length. The extended length of the instrument insertion guide 85 ensures that the tip contacts the upper annular surface 88 of the sealing portion 89 of the wiper seal 84. This advanced instrument guide feature is illustrated by considering the direction of insertion of one surgical instrument 90, as shown in FIG. The surgical instrument in the insertion direction 90a is for the case where, for example, the length of the instrument insertion guide is as shown in FIG. 2 . Thus, the distal tip 91 of the surgical instrument 90 in direction 90a may contact the upper annular surface of the wiper seal at a steep angle, increasing the risk of the tip 91 puncturing or tearing the wiper seal. , in some instances, the contact angle of the tip 91 with the annular surface may prevent the tip 91 from passing through the wiper seal. In contrast, the surgical instrument direction 90b is limited by the length of the instrument insertion guide 85 so that the distal tip 91 of the surgical instrument 90 will contact the upper annular surface of the wiper seal at a relatively sharp angle. , thus reducing the risk of the tip 91 puncturing or tearing the wiper seal, and the annular surface ensures that the tip 91 penetrates the wiper seal much more effectively. As shown, the sealing portion 89 has a configuration similar to that of the sealing portion 65 (FIG. 5), and it should be understood that various sealing portion configurations may be used.

As shown in FIG. 7 , the lengths of the non-return seal 83 and the wiper seal 84 are extended to accommodate the increased length of the instrument insertion guide 85 . The overall length of the seal assembly housing 81 is approximately limited by the depth of the cannula bowl (not shown, see FIG. 2) into which it is inserted. To prevent damage to the non-return seal 83 during normal operation and to prevent the inner surface of the cannula from interfering with the function of the non-return seal 83 when the instrument is inserted, the length of the non-return seal 83 is The non-return seal 83 is configured so that it does not extend through the distal end 88 of the seal assembly 81 when in the closed (sealed) position. The sealing portion 89 of the wiper seal 84 optionally extends as far as possible to the non-return seal 83 so that the non-return seal 83 is resistant to the near-end and lateral movement of the seal 89 and its adjacent flex portion. do not interfere As shown in Figures 7 and 3B, the outer surface of the upper annular groove 93 of the flex section optionally provides additional support for the flex section of the wiper seal 84 and the wiper seal reverses proximally on this outer wall. It may be configured with thick, longitudinal reinforcing ribs 94 to prevent In one embodiment, each reinforcing rib 94 is positioned between adjacent upper support ribs 95 having a width that is approximately half the distance between such support ribs. More or fewer reinforcing ribs 94 may be used in various locations.

Additionally, optional support ribs 96 may be disposed around the outer surface of the instrument insertion guide 85, extending radially outward to provide increased support for the instrument insertion guide 85. The distal ends 97 of the radial support ribs 96 are optionally configured to have the same length as the instrument insertion guide 85 so that the inner annular folds of the flex portion are positioned against the instrument guide 85 as the instrument is pulled through the wiper seal 84. ) and the distal end 97 of the support rib 96. The distal end 97 acts as a proximal longitudinal motion limiting stop and lateral motion guide surface. Thus, the proximity range of motion of the seal 89 is limited regardless of its lateral position within the seal assembly housing. This proximity motion restriction ensures that the wiper seal does not temporarily or permanently catch on the insertion guide when the instrument is removed, particularly if the instrument is removed off its long axis.

Optional radial support ribs 99 may be placed under proximal end 87 of seal assembly 81 to provide additional structural support. The support ribs 96 and 99 can optionally be combined together to form a generally L-shaped support bracket that extends distally along the outside of the instrument guide 85 and then under the top surface of the upper housing.

Example 5

8 is a cross-sectional front view of a portion of another seal assembly embodiment 100 having substantially similar configurations, components, and modifications to other seal assembly embodiments of the present invention. 8 shows a seal assembly 100 comprising a seal assembly housing 101 (including a lower housing 101a and an upper housing 10b), a backflow prevention seal 102 located distally in the lower housing 101a, and a backflow prevention seal 102. Spacer (and optional latch mechanism) 103 positioned over (proximate) anti-seal 102, wiper seal 104 positioned over (proximate) spacer 103, and over (proximate) wiper seal 104 ) and an upper housing 101b positioned thereon. The upper housing 101b is an integrally formed, short, fixed appliance extending radially outward from the insertion guide 105 under the top of the proximity housing 101b, similar to the configuration of the seal assembly 20 shown in FIG. 2 . It includes an insertion guide 105 and a support rib 106.

As shown in FIG. 7 , the wiper seal 104 is configured substantially similar to that of the wiper seal 84 . However, in contrast to the seal assembly shown in FIG. 7 , the seal assembly 100 includes a second, floating device insertion guide 107 attached to the sealing portion 108 of the wiper seal 104, so that device insertion The guide 107 moves proximally (longitudinally) and laterally as the sealing portion 108 moves.

As shown in FIG. 8 , the floating device insertion guide 107 has a substantially cylindrical shape and has a proximal end 109, a distal end 110, an inner wall surface 111, and an outer wall surface 112. In one embodiment, the proximal end 109 of the instrument insertion guide 107 optionally touches or nearly touches the radial support rib 106 to prevent further proximal movement of the instrument insertion guide 107 (and As described above, the wiper seal 104 provides a lateral movement guide surface of the insertion guide 107 ). Thus, the proximal end 109 can slide smoothly laterally while remaining at its proximal range of motion limit by the lower portion of the radial support ribs 106 . The distal end of the fixed instrument insertion guide 105 can optionally be flush with the bottom of the support rib 106 or can extend beyond the bottom of the support rib 106 . Alternatively, an optional spacer can be positioned between the upper housing 101b and the distal end 109 so that the spacer can limit proximal movement of the floating instrument insertion guide 107 . (For example, see FIG. 13A , an anti-reverse piece 152 or a similar ring without flexible fingers 154 is an example of a spacer.) The instrument insertion guide 105 is a boo device insertion guide 107 proximal end 109 ) protrudes inwardly, the diameter of the instrument insertion hole 114 of the proximate housing 101a is smaller than the diameter defined by the inner wall surface 111 of the floating instrument insertion guide 107 at the proximate end 109. Thus, the floating instrument insertion guide 107 can move laterally through its extreme range of motion without the distal end 109 being exposed through the aperture 114, such that no portion of the instrument being inserted remains within the distal end 109 during instrument insertion. will not catch on any part of

The distal end 110 of the floating device insertion guide 107 is in contact with the outer periphery of the sealing portion 108 of the wiper seal 104 . As shown, the distal end 110 is in contact with or near the upper annular fold 115 where the seal 108 engages the flex portion of the wiper seal 104 . 8 shows that the outer wall 112 of the floating instrument insertion guide 107 is optionally below the top of an annular fold 115 to increase the support for contact between the wiper seal 104 and the floating instrument insertion guide 107. (depending on the support rib configuration, a cutout to accommodate the support ribs in the flex portion that may be included, or other distal end 110 configuration). Similarly, FIG. 8 shows that the inner wall 111 of the floating instrument insertion guide 107 optionally has an annular fold 115 to provide a smooth transition between the side wall 111 and the upper surface 116 of the sealing portion 108. It is shown that it can be stretched under the top. As shown, the exterior of the top surface 116 of the sealing portion 108 is concave, as described above, to further provide a smooth surface transition between the sidewall 111 and the top surface 116. In some embodiments, the floating insertion guide 107 simply rests against the wiper seal 104 and is held in place by the construction of the assembly. In other embodiments, the floating instrument insertion guide 107 may be secured to the wiper seal 104, for example by an adhesive or bonding process (eg, using Loctite® 4011™), or by mechanical attachment. can Additionally, one skilled in the art will understand that the instrument insertion guide can be attached to various locations on the wiper seal to allow for lateral movement of the insertion guide within the seal assembly housing.

As shown in FIG. 8 , the inner wall 111 of the floating instrument insertion guide 107 is optionally provided to assist in guiding the instrument tip toward the upper surface of the sealing portion 108 of the wiper seal 104 and to such upper surface. It can be made slightly concave to provide a smooth transition to . However, in other embodiments, other inner wall configurations of the floating instrument insertion guide (eg flat, convex, compound, etc.) may be used as described below.

Example 6

9 is a cross-sectional front view of a portion of another seal assembly embodiment 117 having substantially similar configurations, components, and modifications to other seal assembly embodiments of the present invention. 9 shows a seal assembly 117 comprising a seal assembly housing 118 (including a lower housing 118a and an upper housing 118b), a non-return seal 119 located distally within the distal housing 118a, and a backflow prevention seal 119. Spacer (and optional latch mechanism) 120 positioned over (proximate) anti-seal 119, wiper seal 121 positioned over (proximate) spacer 120, over (proximate) wiper seal 121 ) positioned proximal housing 118b. Seal assembly 117 also includes a floating instrument insertion guide 122 whose components are configured generally as described for seal assembly 100 (FIG. 8), along with various other associated seal assemblies 117. 9 shows an alternative construction of the inner wall of the floating instrument insertion guide.

As shown in FIG. 9 , the inner wall 123 of the floating device insertion guide 122 includes a top 124 adjacent its proximal end 125 and the top 124 adjacent its distal end 127. There is a smooth transition to the lower part 126. The upper portion 124 has a slight concave shape (or optionally straight or convex shape) and the lower portion 126 is planar (or optionally concave or convex). The cylindrical, vertical side wall of the lower part 126 forms a relatively less steep angle to the sealing top surface 128 of the wiper seal 121 than, for example, the transition described in FIG. 8 . Nonetheless, the vertical sidewall of the lower portion 126 limits the insertion direction angle of the device itself, resulting in improved instrument tip insertion through the wiper seal 121 with a lower catch-on tendency of the upper surface 128 of the instrument tip. found that it can be obtained. Thus, it can be seen that many floating instrument insertion guide inner wall configurations exist. Additionally, it is also possible to similarly construct the inner wall of a stationary instrument insertion guide (see, eg, instrument insertion guide 85 in FIG. 7 ) in the seal assembly housing as an option.

Example 7

10 is a cross-sectional elevational view of a portion of another seal assembly embodiment having substantially similar configurations, components, features, and modifications to other seal assembly embodiments of the present invention. 10 shows a seal assembly 129 comprising a seal assembly housing 130 (including a lower housing 130a and an upper housing 130b), a non-return seal 131 located distal to the yarn of the lower housing 130a, Spacer (and optional latch mechanism) 132 positioned over (proximate) non-return seal 1310, wiper seal 133 positioned over (proximate) spacer 132, and over (proximate) wiper seal 133 The seal assembly 129 also has various other associated seal assemblies 129, as well as components approximately the seal assembly 100 (FIG. 8) and 117. ) (Fig. 9), and a floating instrument insertion guide 134 configured as described above. Figure 10 shows an alternative configuration of the distal end 135 of the floating instrument insertion guide and the corresponding wiper seal.

As shown in FIG. 10 , the distal end 135 of the floating device insertion guide 134 includes an annular groove 136 between inner and outer wall surfaces of the insertion guide. The wiper seal 133 includes an annular boss 137 extending upward (in a proximal direction) from a position where the sealing portion of the wiper seal 133 engages the flex portion thereof. The annular boss 137 fits into the inner annular groove 136 to help secure the floating instrument insertion guide 134 to the wiper seal 133. In the illustrated embodiment, the deepest (orientated closest when assembled) portion of the annular groove 136 is tapered so that sufficient material thickness exists between the groove sidewall and the insertion guide inner wall, and the annular boss 137 ) is beveled to match the tapered shape. An annular groove to ensure that the distal end 134a of the instrument guide 134 contacts the upper annular surface 133b of the sealing portion 133a of the wiper seal 133 to form a smooth surface transition between the two components. There is a small gap between 136 and the annular boss 137. This spacing also ensures sufficient space for the bonding adhesive used to couple the annular boss 137 and the insertion guide 134. Optional mechanical attachments may be used. This coupling arrangement between the wiper seal 133 and the floating instrument insertion guide 134 is such that as the instrument is inserted into the seal assembly 129, the wiper seal 133 and instrument insertion guide 134 can be separated from the instrument tip. helps to resist the lateral forces of

seal assembly latch

11 shows an upper portion of a combination of spacer and latch pieces 138 for a seal assembly, including a ring-shaped spacer portion 139 and two latches 140 positioned opposite to each other on the periphery of the spacer portion 139. It is a perspective view. At the inner periphery of the spacer portion 139, a raised annular boss 141 extends proximally. As shown, the spacer portion 139 and the latch 140 are integrally formed as a single piece. In one embodiment, this combination of spacer latches 138 is made of flexible polycarbonate, although other materials may be used provided they provide adequate flexibility for a U-shaped bend as described below. And, while two latches 140 are shown, other embodiments include a single latch and three or more latches. As discussed below, a single latch according to the disclosed features will effectively latch the seal assembly to the cannula.

The spacer portion 139 functions as generally shown and described above (43 in FIG. 2, 103 in FIG. 8, 120 in FIG. 9, 132 in FIG. 10). When the spacer and latch piece 138 is assembled to the seal assembly, the annular boss 141 is aligned between the portions of the upper and lower seal assembly housings so that the periphery of the wiper seal is flush with the upper housing piece and the annular spacer portion 139. ), and the periphery of the anti-backflow seal is sandwiched and compressed between the lower housing piece and the annular spacer 139. This slight compression forms an airtight seal. The annular boss 141 may optionally be positioned at or near the outer periphery of the spacer portion 139, or may be positioned between its inner periphery and outer periphery. In some embodiments, the annular boss may extend distally. Two or more annular bosses may be used in various combinations.

12 is a cross-sectional view of the latch portion 140 of the spacer and latch 138 in the seal assembly coupled to the cannula. The latch part 140 includes a U-shaped elastic bent part 142 coupled to the spacer part 139 at one end. At the other end, the bent portion 142 is coupled to the middle region of the latch piece 143 . Above (close to) the intermediate region where flexure 142 is coupled to latch piece 143 is a patterned finger tab 144 that aids in gripping (eg, by a finger covered by a surgical glove). Below (at the distal end) of the middle region is a latch tab 145 comprising a finger 146 extending laterally inward towards the spacer portion 139, and a catch 147 below the finger 146 to the spacer 139. It is oriented inward to the side. Catch 147 optionally includes an inward-facing distal inclined lead-in surface 148 to assist in latching onto the cannula after catch 147 is bent radially outward when the seal assembly is compressed into the cannula bowl.

In use, latch piece 143 rotates around the post formed by bend 142 so that latch tab 145 moves radially outward as pinker tab 144 moves radially inward. When the seal assembly is inserted into the cannula bowl at the proximal end of the cannula, the lead-in surface 148 contacts the cannula bowl flange 149a, causing the latch tab 145 to move outward. Once catch 147 is at the distal end of cannula bowl flange 149a, bend 142 returns latch tab 145 to its original position, positioning catch 147 under cannula bowl flange 149a. Thus, the seal assembly is removably latched onto the cannula 149. The latch portion 140 has sufficient elasticity to latch the cannula bowl without compressing the finger tab 144 when the seal assembly is compressed into the cannula bowl, and the seal assembly retains the cannula until the finger tab 144 is compressed. It has sufficient rigidity so that it does not separate from the bowl.

As shown in FIG. 12 , when the seal assembly is latched onto the cannula bowl, the cannula bowl flange 149a and seal assembly housing relief surface (shoulder) 150 engage the underside (distal end) of the catch 147 and fingers 146. ) is located between the surfaces. As a result, when attempting to remove the seal assembly from the cannula bowl, the catch 147 contacts the underside of the cannula flange 149a, and the upper (proximal) surface of the seal assembly housing relief surface (shoulder) 150 is fingered. Contact the underside of 146 to prevent the seal assembly from being removed from the cannula bowl. An advantage of this latch configuration is that a holding force is maintained between the catch 147 and the finger 146 without moving into the bent portion 142 . Additionally, the design of the latch tab 145 allows the seal assembly to rotate about its long axis without limitations inside the cannula bowl, as described in more detail below. Also, if only one of the two latch portions is engaged with the cannula flange, the proximity force on the seal assembly will tend to rotate the seal assembly around the engaged latch portion, then the lower portion of the seal assembly housing (e.g., FIG. 2 ). 22) will contact the inner wall of the cannula bowl, preventing the seal assembly from being removed from the cannula. Accordingly, both latch portions 140 must be released by squeezing the finger tabs 144 to remove the seal assembly from the cannula. Inadvertent unlatching can be further prevented by positioning a physical guard proximate the finger tab 144, as described below (eg, see 157 of FIG. 13B).

anti-reverse piece

13A is a top perspective view of the seal assembly 151 with the top of the housing removed to show an embodiment of an optional seal anti-reverse piece 152 positioned over (proximate) the wiper seal, and FIG. 13B is a top view of the housing. is a top perspective view of the seal assembly 151 in place. 13A and 13B, the outer circumferential area 153 of the anti-reverse piece 152 functions as a spacer between the upper outer circumferential surface of the wiper seal and the lower surface of the upper portion of the seal assembly housing (e.g., FIG. 2 see spacer 45 in ). The anti-inversion piece 152 includes a plurality of (16 shown) anti-inversion fingers 154 extending radially inward from the outer circumferential region 153, the tips 155 of the fingers 154 serving as surgical instruments. forms a central hole 156 into which is inserted. The diameter of aperture 156 may optionally be greater than, equal to, or less than the smallest diameter surgical instrument shaft that seal assembly 151 is designed to receive. As shown, the fingers 154 are optionally formed in a helical pattern, although other patterns may be used (e.g., extending straight inward, extending inward at any angle, etc.). Thus, more generally, the finger can optionally be configured in two ways, one type where the tip of the finger is radially aligned with the finger hinge point near the circumference, and another type where the tip of the finger is radially aligned with the finger hinge point near the circumference. It is radially offset (clockwise or counterclockwise) from the finger hinge point.

The anti-inversion piece 152 is made of a flat, rigid but elastic material, so that if the finger 154 bends down (distal) when the device is inserted, the anti-inversion piece 152 will deflect it when the device is withdrawn. Return to flat configuration. Unlike straight, radial fingers, spiral pattern fingers move radially outward and overlap, so they don't get caught in the part of the device that is missing. Other finger patterns including straight and radial fingers may be used as described below.

As shown in FIG. 13B, the top of the seal assembly housing extends radially inward half way over the fingers so that only the tip 155 is visible through the instrument insertion hole in the top of the seal assembly housing. In operation, the fingers 154 are long enough to readily bend downward when a surgical instrument is inserted into the seal assembly. When the instrument is withdrawn, the fingers prevent the underlying wiper seal from inverting through the instrument insertion hole at the top of the seal assembly housing. One or more tips 155 catching on a portion of an instrument (eg, a wrist assembly or a surgical end effector) by allowing the tip 155 to slightly extend into the longitudinal cylinder formed by the instrument insertion hole in the housing. In this case, the tip may be bent slightly upward (proximally) through the hole and the device may be dislodged. The inner periphery of the upper housing forming this hole acts as a support for the tip 155 when the instrument bends the tip upward. Tip 155 is optionally rounded and/or lubricated to reduce friction between the tip and the surgical instrument shaft during normal use. In one embodiment, the anti-reflection piece 152 is made of high density polyethylene with 2 percent silonic acid (ie, HDPE with molten silicone for lubricity). Other flexible, durable plastics may be used.

13C is a plan view of the anti-reverse piece 152. As shown, sixteen equal-length-spiral-patterned fingers 154 are formed by sixteen corresponding spiral-pattern cuts 154a. A crack-stop hole 154b is formed at the outer radial end of each cut 154a to help prevent material failure as the finger bends distally and displaces radially outward. These crack-stop holes can optionally be used on all anti-reverse piece embodiments. As shown, each tip 155 of the fingers 154 is approximately square and can optionally have a rounded shape to help prevent catching at surgical instrument components to reduce friction against the instrument shaft. .

13D is a plan view of the anti-reverse piece 152a. As shown, the anti-reverse piece 152a includes a plurality of spiral pattern fingers 154c extending radially inward from the outer circumference 153a, each spiral pattern finger 154c having a shorter spiral pattern subfinger. (154d). As shown in FIG. 13D, there are four spiral pattern fingers 154c each separated into four subfingers 154d. The cuts forming the spiral pattern fingers 154c extend radially outward at about 80 percent of the radius of the anti-return piece 152a, and the cuts forming the spiral pattern subfingers 154d are It extends radially outward about 55 percent of its radius. Relative lengths between other fingers and subfingers may be used. For example, FIG. 13E is a plan view of the anti-reverse piece 152b. As shown in FIG. 13E, the cuts forming the spiral pattern fingers 154e extend radially outward to about 80 percent of the radius of the anti-reverse piece 152b, and the cuts forming the spiral pattern subfingers 154f extends radially outward at about 40 percent of the radius of the anti-reverse piece 152b. Thus, in one feature, the length of the cut forming the subfinger is between about 40 and 55 percent of the radius, but other cut lengths may be used to form the fingers and subfingers. The spiral pattern fingers and subfingers operate to open and twist when the device is inserted or pulled out, and the shorter range of motion of the subfingers during this opening and twisting keeps the bent subfingers on the upper annular surface of the wiper seal sealing part, , to protect the annular face from sharp instrument tips.

Although the spiral pattern feature of the anti-reverse piece is a desirable characteristic, in other anti-reverse piece embodiments, straight inner radial fingers may optionally be used. For example, FIG. 13F is a top view of an anti-return piece 152c having a plurality of equal length straight fingers 154g extending radially inward from the outer circumferential region 153b. There are 18 fingers 154g in FIG. 13F, other numbers of fingers may optionally be used. For example, FIG. 13G shows an embodiment where 12 straight radial fingers are used, and FIG. 13H shows an embodiment where 6 straight radial fingers are used. As shown in Figures 13f, 13g, and 13h, the radial cuts forming the fingers are relatively narrow, so that as the number of radial fingers decreases, the width of each individual finger correspondingly increases. 13G and 13H also show that inner tips 155a (FIG. 13G) and 155B (FIG. 13H) have a circular shape to catch on the device component as it is inserted and withdrawn through the anti-reverse piece. can help prevent this, reducing friction on the machine shaft.

Additionally, the finger and subfinger configurations described above for the spiral pattern fingers of FIGS. 13D and 13E may optionally be used for radial straight fingers. For example, FIG. 13I shows an anti-reverse piece 152d comprising a plurality of straight fingers 154h extending inwardly from outer circumferential region 153b, each individual finger 154h being a subfinger 154i. separated by As shown, the anti-reverse piece 152d includes four fingers 154h, and each finger 154h includes three subfingers 154i. The cut forming the finger 154h extends to about 80 percent of the radius of the anti-reverse piece 152d, and the cut forming the sub-finger 154i extends to about 55 percent of the radius of the anti-reverse piece 152. Again, a variety of other cut lengths may be used to form fingers and subfingers.

Other housing features

13B also shows two additional seal assembly housing features. As shown, the housing of seal assembly 151 optionally includes a guard 157 on either side of each latch finger tab 144 that extends radially outward into the housing. The guard 157 helps prevent the associated finger tab 144 from being inadvertently pressed inward to release the seal assembly from the cannula.

Also shown in FIG. 13B, the housing of seal assembly 151 optionally includes two latch windows 158 on its upper surface, which windows are described above with reference to FIG. 2 and in more detail below. As such, it is used to optionally latch other medical devices, such as the obturator described below, to the upper surface of the housing. Also, the upper surface 151a of the housing 151 is flat and smooth along the arc between the windows 158. This top configuration allows the component to be radially centered in the housing and rotated clockwise or counterclockwise until the component's latch drops into window 158 .

sealer

14 is a perspective view of an example of a sealer 159 that includes a sharp 160, a tip 61 at the distal end of shaft 160, and a proximate portion 162 at the proximal end of shaft 160. Two latches are located on either side of the proximity portion 162, and these latches 163 are used to secure the obturator 159 to the top of the seal assembly. The materials used in these sealers are similar to those used in seal assemblies.

15A is a cross-sectional view of a proximate portion 164 of an example obturator coupled to the top of seal assembly 165 . As shown in FIG. 15A , obturator shaft 166 extends through seal assembly 165 . Two resilient latch bends 167 are located on either side of the proximal end of the obturator shaft 166. At the distal end of the bend 167, a catch 168 inserted through the window 169 on the top surface of the seal assembly 164 and catching under the lip of the top of the seal assembly housing forming each window 169 there is These latches hold the obturator firmly against the seal assembly. The catch 168 is optionally beveled so that the seal assembly can be latched onto the seal assembly by pushing the seal assembly distally after the seal has been rotated so that the catch can drop into the window 158. The latch bend 167 also includes a finger tab 170, and by compressing the finger tab 170 radially inward, the catch 168 moves radially inward so that the sealer can be removed from the seal assembly.

FIG. 15B is a cross-sectional view of an example proximity portion 164 coupled to the top of seal assembly 165, taken at right angles to the view of FIG. 15A. The seal assembly cross section shown is similar to that shown in FIG. 12 . 15B shows that the obturator proximal portion 164 includes two distally protruding interference tabs 164a. When the obturator is fully seated on the top surface of the seal assembly, each of these interference tabs 164 is between the top 165a of the seal assembly housing and the finger tab 144 so that the finger tab 144 is pressed radially inward. This prevents the obturator and seal assembly combination from unlatching from the cannula flange 149a.

12 and 15B, the latch piece 143 feature allows the seal assembly to be securely latched to the cannula 149 and the seal assembly and any components coupled thereto rotate around the long axis A inside the cannula 149. It can be seen that it can rotate without restriction. The cannula bowl flange 149a and the seal assembly housing relief face (shoulder) 150 are held between the fingers 146 and the catch 147 of the latch 143, and are caught by the soft underside of the cannula flange 149. 147 moves without interference, and O-ring 165b maintains an airtight seal between the seal assembly and the inner wall of the cannula bowl. One or more optional stops (not shown) may be disposed on the underside of the cannula flange 149 to limit the amount the seal assembly can rotate about its long axis within the cannula bowl. The ability to rotate in the cannula bowl of the seal assembly provides the ability to orient the fluid inlet/outlet valve of the seal assembly in any desired direction or reorient the valve as needed during use, as shown below. And, the ability to rotate the yarn in the cannula bowl allows the yarn to be initially latched to the cannula in a variety of orientations and then rotated as needed for use, such that perfect yarn orientation alignment is not required for initial latching.

In one feature, the combination of the cannula, seal assembly, and obturator is an assembly. This seal assembly allows the obturator to be coupled to the cannula. 16 includes cannula 172, seal assembly 173 latched to cannula 172, and obturator 174 latched to seal assembly 173 and extending through cannula 172 and seal assembly 173. is a perspective view of the medical device assembly 171. The top (proximal end) of obturator 174 has a circular shape to accommodate a palm. In use, the surgeon inserts the distal end of the medical device assembly 171 through the patient's body wall, and once the medical device assembly 171 is inserted, the surgeon unlatches the obturator 174 and seals assembly 173 and Pulled from cannula 172, another medical device, such as an endoscope or therapeutic surgical instrument, can be inserted through thread assembly 173 and cannula 172 to reach the surgical site.

In another feature, a radially centered hole (not shown) is disposed in the obturator proximal portion 164, and at least the obturator tip 161 is made transparent. Such transparent sealer tips are known. The endoscope is inserted into the obturator tip (161) through the radially centered hole and through the obturator shaft (163). This transparent obturator tip allows the surgeon to see the insertion through the body wall. Thus, in one feature, the combination of a cannula, a seal assembly, an obturator with a transparent distal end, and an endoscope inserted within the obturator is an assembly. This seal assembly allows the obturator to be coupled to the cannula.

As shown, cannula 172 is configured to be mounted on a teleoperated medical device manipulator that is part of a teleoperated surgical system, such as the system sold by Intuitive Surgical, Inc., Sunnyvale, Calif. However, in other embodiments, medical device assembly 171, or one of its components, may be used for non-remotely controlled surgical procedures, such as manual laparoscopic procedures.

remote controlled medical device

17 is a perspective view of a cannula 175 and seal assembly 176 fitted together and coupled to the distal end of a teleoperated manipulator 177, which is part of a teleoperated surgical system. Seal assembly 176 represents various seal assembly configurations described herein. It can be seen that valve 176a of seal assembly 176 can rotate either clockwise or counterclockwise on cannula 175, as indicated by the double-headed arrow. Associated by the ability to orient one or more valves 176a when multiple cannulas 175 and seal assemblies 176 are inserted into a patient in proximity, each combination docked with a corresponding manipulator 177. The tubing can be more easily coupled to valve 176a and more effectively routed in a sterile field around various other cannula entry ports into the patient. Additionally, the valve orientation can be changed while the instrument is being inserted through the seal assembly and cannula.

18 is a perspective view of an example of a teleoperated medical device 178 - a teleoperated surgical system (part of the patient side component of the da Vinci Xi® Surgical System) - incorporating at least one cannula 175 and seal assembly 176. . As shown in FIG. 18 , example surgical instrument 179 is mounted on the distal end of manipulator 177, and shaft 180 of surgical instrument 179 extends through seal assembly 176 and cannula 175. there is. In some examples, each of the one or more seal assemblies accommodating one range of instrument shaft sizes as described (eg, 5-8 mm) is used with one or more corresponding instrument manipulators, and the instrument as described One or more other seal assemblies accommodating different ranges of shaft sizes (eg 10-12 mm) are used with one or more other corresponding manipulators.

Accordingly, it can be seen that the thread assembly is generally not only for minimally invasive surgery, but is an important component for enabling the remotely operated surgical system to operate effectively. As an example of use, the thread assembly and cannula combination is mounted on the distal end of each of the four manipulators of the telecontrolled medical device 178 so that various surgical instruments can be inserted through one or more ports on the patient to reach the surgical site. . A single seal assembly accommodating various instrument shaft diameters allows the telecontrolled medical device 178 to simultaneously use a variety of instruments with different shaft diameters, and operation is simplified by using the same seal configuration for each cannula. The reason is that there is no need for a dedicated different seal assembly to be used for only one surgical instrument shaft diameter. Thus, surgical instruments with different diameters can be interchanged between the two manipulators, if necessary, without the need to change the seal assembly for each cannula.

Claims (14)

In medical devices,
a seal assembly housing comprising an upper portion;
a wiper seal in which an instrument insertion hole is formed; and
An instrument insertion guide positioned between the wiper seal and the seal assembly housing to surround the instrument insertion hole;
the instrument insertion guide is coupled to the wiper seal;
wherein the instrument insertion guide is laterally movable relative to the seal assembly housing. According to claim 1,
The wiper seal includes a sealing portion in which an instrument insertion hole is formed;
The sealing part includes an upper surface;
The medical device of claim 1 , wherein the instrument insertion guide includes an inner sidewall extending below an upper surface of the sealing portion. According to claim 1,
the wiper seal includes an annular corrugation and an annular boss;
An annular corrugation contains close annular folds;
an annular boss extends proximally from the annular fold;
the instrument insertion guide includes a distal end and an annular groove formed at the distal end of the instrument insertion guide;
The medical device of claim 1 , wherein the annular boss of the wiper seal is within an annular groove of the instrument insertion guide. In medical devices,
a seal assembly housing, a wiper seal, and an instrument insertion guide;
The seal assembly housing includes a top portion;
An instrument insertion hole is formed on the top of the seal assembly housing;
The instrument insertion guide is fixed to the top of the seal assembly housing and surrounds the instrument insertion hole;
the wiper seal is coupled to the seal assembly housing at a first depth;
wherein the instrument insertion guide extends distally into the seal assembly housing at a second depth distal to the first depth. In medical devices,
seal assembly housing;
a wiper seal including an outer circumferential portion coupled to the seal assembly housing, an inner sealing portion, and a flex portion between the outer circumferential portion and the inner sealing portion; and
A medical device comprising: an instrument insertion guide between a wiper seal and a seal assembly housing and having a proximity instrument insertion aperture. According to claim 5,
the instrument insertion guide is coupled to the wiper seal and separated from the seal assembly housing;
wherein the instrument insertion guide is laterally movable relative to the seal assembly housing. According to claim 5,
The medical device of claim 1 , wherein the instrument insertion guide includes one or more support ribs extending radially outward from an outer surface of the instrument insertion guide. According to claim 5,
wherein the flex portion of the wiper seal contacts the distal end of the instrument insertion guide. According to claim 5,
Device insertion guides:
a first device insertion guide coupled to the seal assembly housing and including a proximity device insertion hole; and
A medical device comprising a second instrument insertion guide coupled to a wiper seal. According to claim 9,
wherein the second instrument insertion guide is laterally movable relative to the seal assembly housing. According to claim 9,
The medical device of claim 1 , wherein the outer and inner walls of the second instrument insertion guide extend below proximal portions of the flex portion of the wiper seal. According to claim 5,
the instrument insertion guide is coupled to the wiper seal and separated from the seal assembly housing;
The medical device of claim 1 , wherein the instrument insertion guide includes an inner wall at least partially concave. According to claim 5,
the instrument insertion guide is coupled to the wiper seal and separated from the seal assembly housing;
The instrument insertion guide includes an inner wall, the inner wall comprising:
an upper portion proximal to the instrument insertion guide; and
a lower portion adjacent to a distal end of the instrument insertion guide;
A medical device, wherein at least a portion of the upper portion is concave and the lower portion is planar. According to claim 5,
the instrument insertion guide is coupled to the wiper seal and separated from the seal assembly housing;
The distal end of the instrument insertion guide includes an annular groove between an inner wall and an outer wall of the instrument insertion guide;
The wiper seal includes an annular portion boss extending proximally from a position where the inner sealing portion is coupled to the flex portion;
wherein the annular boss of the wiper seal is received into an annular groove of the instrument insertion guide.

Images